抗生剤によるビタミンK欠乏性凝固異常のために硬膜外カテーテル抜去に難渋した3症例

Three Cases Becoming Difficult to Remove Epidural Catheter Postoperatively Due to Coagulation Defect Associated with Antibiotics

Hirata Yuri

Miyoshi Hirotsugu

Nakamura Ryuji

Masuda Yoko

Kondo Takashi

Kato Takahiro

Yasuda Toshimichi

Hamada Hiroshi

Kawamoto Masashi

麻酔と蘇生

Ansesthesia and Resuscitation

Perioperative vitamin K deficiency can cause severe coagulopathy rapidly. Vitamin K deficiency tends to be overlooked despite the elucidation of pathophysiology and countermeasures. The main causes of vitamin K deficiency are insufficient intake, low supply from intestinal bacteria, and synthesis inhibition of vitamin K by N-methyltetrazolethiol (N - MTT) contained antibiotics. We experienced three cases in which it was difficult to remove epidural catheter because of coagulation abnormality due to vitamin K deficiency after surgery. Vitamin K deficiency should be wary of when epidural catheter is indwelled or withdrawn from a patient who is administered with antibiotic containing N-MTT in the fasted state.

ビタミンK欠乏症

硬膜外麻酔

抗生剤

NMTT 基

PIVKA-II

vitamin K deficiency

epidural anesthesia

antibiotic

N-methyltetrazolethiol

Medical sciences [ 490 ]

jpn

広島麻酔医学会

[ISSN] 0385-1664

[NCID] AN00232251